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Abdominal Pain in Patients with Gastroparesis: Associations with Gastroparesis Symptoms, Etiology of Gastroparesis, Gastric Emptying, Somatization, and Quality of Life

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Abstract

Abdominal pain can be an important symptom in some patients with gastroparesis (Gp).

Aims

(1) To describe characteristics of abdominal pain in Gp; (2) describe Gp patients reporting abdominal pain.

Methods

Patients with idiopathic gastroparesis (IG) and diabetic gastroparesis (DG) were studied with gastric emptying scintigraphy, water load test, wireless motility capsule, and questionnaires assessing symptoms [Patient Assessment of Upper GI Symptoms (PAGI-SYM) including Gastroparesis Cardinal Symptom Index (GCSI)], quality of life (PAGI-QOL, SF-36), psychological state [Beck Depression Inventory (BDI), State-Trait Anxiety Index (STAI), PHQ-15 somatization scale].

Results

In total, 346 Gp patients included 212 IG and 134 DG. Ninety percentage of Gp patients reported abdominal pain (89% DG and 91% IG). Pain was primarily in upper or central midline abdomen, described as cramping or sickening. Upper abdominal pain was severe or very severe on PAGI-SYM by 116/346 (34%) patients, more often by females than by males, but similarly in IG and DG. Increased upper abdominal pain severity was associated with increased severity of the nine GCSI symptoms, depression on BDI, anxiety on STAI, somatization on PHQ-15, the use of opiate medications, decreased SF-36 physical component, and PAGI-QOL, but not related to severity of delayed gastric emptying or water load ingestion. Using logistic regression, severe/very severe upper abdominal pain associated with increased GCSI scores, opiate medication use, and PHQ-15 somatic symptom scores.

Conclusions

Abdominal pain is common in patients with Gp, both IG and DG. Severe/very severe upper abdominal pain occurred in 34% of Gp patients and associated with other Gp symptoms, somatization, and opiate medication use.

ClinicalTrials.gov Identifier: NCT01696747.

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Acknowledgment

The Gastroparesis Clinical Research Consortium (GpCRC) is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grants U01DK073983 (Pasricha), U01DK073975 (Parkman), U01DK073985 (Hasler), U01DK074007, U01DK073974, U01DK074008 (Tonascia), U01DK112193 (Kuo).

Author information

Authors and Affiliations

  1. Gastroenterology Section, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, Philadelphia, PA, 19140, USA

    Henry P. Parkman & Ron Schey

  2. Johns Hopkins University, Baltimore, MD, USA

    Laura A. Wilson, John Clarke, Laura Miriel, James Tonascia & Pankaj J. Pasricha

  3. University of Michigan, Ann Arbor, MI, USA

    William L. Hasler

  4. Texas Tech University, Lubbock, USA

    Richard W. McCallum & Irene Sarosiek

  5. Wake Forest University, Winston-Salem, NC, USA

    Kenneth L. Koch

  6. University of Louisville, Louisville, KY, USA

    Thomas L. Abell

  7. Harvard Medical School, Boston, USA

    Braden Kuo

  8. California Pacific Medical Center, San Francisco, CA, USA

    William J. Snape

  9. Stanford University, Palo Alto, CA, USA

    Linda Nguyen

  10. Mayo Clinic, Rochester, MN, USA

    Gianrico Farrugia & Mandhusudan Grover

  11. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

    Frank Hamilton

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  1. Henry P. Parkman
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  18. Pankaj J. Pasricha
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Corresponding author

Correspondence to Henry P. Parkman.

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Conflict of interest

No conflicts of interest exist.

Author’s contribution

Henry P. Parkman helped in study conceptualization, patient recruitment, data interpretation, writing manuscript; Laura A. Wilson contributed to statistical analysis, data interpretation, writing manuscript; William L. Hasler, Richard W. McCallum, Irene Sarosiek, Kenneth L. Koch, Thomas L. Abell, William J. Snape, Linda Nguyen, and Pankaj J. Pasricha helped in study conceptualization, patient recruitment, revising manuscript; Ron Schey, Braden Kuo, and John Clarke contributed to patient recruitment, revising manuscript; Gianrico Farrugia, Mandhusudan Grover, Laura Miriel, and Frank Hamilton helped in study conceptualization, revising manuscript; and James Tonascia contributed to study conceptualization, statistical analysis, data interpretation, revising manuscript.

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Parkman, H.P., Wilson, L.A., Hasler, W.L. et al. Abdominal Pain in Patients with Gastroparesis: Associations with Gastroparesis Symptoms, Etiology of Gastroparesis, Gastric Emptying, Somatization, and Quality of Life. Dig Dis Sci 64, 2242–2255 (2019). https://doi.org/10.1007/s10620-019-05522-9

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